RU225832U1 - Bartholin gland drainage device - Google Patents

Abstract

The utility model relates to the field of medicine, in particular to gynecology, namely to a device for draining a Bartholin gland cyst. A device for draining a Bartholin gland cyst in gynecology, including a body in the form of a hollow cylinder and drainage holes located in it, and also including two holes for fixation. The holes for fixation are made in the form of ears, radially located on the body. The technical result consists in simplifying the design of the device while ensuring simple and effective fixation.

Description

The utility model relates to the field of medicine, in particular to gynecology, namely to a device for draining a Bartholin gland cyst.

A Bartholin gland cyst is a unilateral or rarely bilateral formation in the area of the lower third of the vestibule of the vagina, formed as a result of a violation of the outflow of secretions from the Bartholin gland. Bartholin's gland abscess is a purulent inflammation of the Bartholin's gland of microbial origin. The incidence of these pathologies reaches 2% of all gynecological visits per year. At the same time, a Bartholin gland abscess is diagnosed approximately three times more often than a Bartholin gland cyst.

Abscesses and cysts of the Bartholin glands greater than 2 cm in diameter require surgical treatment, an option of which is the installation of a Bartholin gland catheter (Dole DM, Nypaver C. Management of Bartholin Duct Cysts and Gland Abscesses. J Midwifery Womens Health. 2019 May;64(3): 337-343. doi: 10.1111/jmwh.12937. Epub 2019 Feb 7. PMID: 30734519). Currently, only one system is widely used in clinical practice for long-term catheterization of Bartholin gland cysts (21-45 days): the Word catheter. The basis of this system is a balloon fixed in the cyst cavity, allowing the catheter to remain in the cyst for a long time and form an artificial excretory duct of the gland (Rotem R, Diamant C, Rottenstreich M, Goldgof M, Barg M, Greenberg N, Sheizaf B, Weintraub AY. Surgical Treatment of Bartholin's Gland Abscess: Is Word Catheter Superior to Marsupialization? J Minim Invasive Gynecol. 2021 Jun;28(6):1211-1215. doi: 10.1016/j.jmig.2021.01.006 Epub 2021 Jan 15. PMID: 33460773) .

The disadvantages of such a system include its complexity and relatively low efficiency. The first is due to the large number of components, which causes both difficulties in use and difficulties in providing the clinic with such a set. Low efficiency is caused by the lack of possibility of washing and fixation using suture material, which worsens surgical hemostasis. In addition, the use of a balloon if its integrity is violated can lead to spontaneous loss of the catheter.

A known drainage catheter of the Bartholin gland (Bartholin gland drainage catheter: European patent appl. EP2727621A1, filed 10/18/2013, publ. 05/07/2014), containing a rod having an outer diameter, a proximal end and a distal end, as well as a drainage lumen passing between the corresponding ends The distal end of the rod contains a Malecott-type retention mechanism with multiple flared wings that secure the catheter inside the Bartholin gland. The wings are selectively moved from a first radially expanded position to a second radially compressed insertion position. The proximal end of the catheter shaft contains a fixation element, the outer diameter of which exceeds the outer diameter of the shaft, which remains outside the patient's lip tissue. The catheter is inserted into the gland, with the Malecote remaining in a compressed configuration and then allowed to expand within the gland, thereby locking the catheter in place to facilitate drainage and healing of the cystic gland.

The disadvantages of this device include the complexity of its design, due to the complexity of the locking mechanism and the need to use a handle both for inserting and removing the catheter. The presence of a locking mechanism in this device requires the use of dense structures, which can lead to painful sensations when worn by the patient.

The closest to the claimed utility model is a device for draining a Bartholin gland cyst in gynecology (Gynecology bartholin gland cyst drainage strip: Chinese Patent CN203060384, appl. CN201220754845. 12/30/2012, 07/17/2013), including a body in the form of a hollow cylinder and located in it drainage holes and fixation holes. Moreover, near the fixation holes there is a fastening mechanism.

The disadvantage of this device is the difficulty of its fixation, due to the implementation of a rather complex fixation system. In addition, the fixation procedure itself with a fastening mechanism is quite complicated for the surgeon, which in some cases can lead to insufficiently strong fixation and injury.

The technical problem is the need to develop an effective device for draining the Bartholin gland, devoid of the above disadvantages.

The technical result consists in simplifying the design of the device while ensuring simple and effective fixation.

The technical result is achieved by the fact that in a device for draining a Bartholin gland cyst in gynecology, which includes a body in the form of a hollow cylinder and drainage holes located in it, and also includes two holes for fixation, according to the utility model, the holes for fixation are made in the form of ears, radially located on the body.

This design is simpler and provides simple and effective fixation due to suture material: two sutures fix the gland capsule to the mucous membrane and to the ears through the holes located in them. Effective hemostasis is achieved in the same way.

The inventive model is illustrated by drawings, where the figure shows drainage holes 4, 5, as well as holes 2 for passing the fixing thread.

A device for draining a Bartholin gland cyst contains a housing 1 made of plastic material. Housing 1 has the shape of a hollow cylinder. The body 1 is preferably made of silicone or latex. Preferably, the plastic material of the body 1 has a Shore A hardness of 75 to 82, most preferably 78. On the body 1 there are elliptical “ears” 3, each of which contains a hole 2 for passing the fixing thread. The “ears” 3 are located coaxially near the edge of the housing 1. The housing 1 is made with two drainage holes 4 (on the side), located closer to the middle, out of alignment with each other and radially with respect to the housing when viewed in cross section. Preferably, the distance between the edges of the housing 1 and the holes 4 closest to them, as well as between the holes 4, is the same. Housing 1 also contains drainage holes 5 located at the ends (due to which a hollow cylinder is formed).

It is clear to the specialist that the preferred embodiment of the device is described above, which does not limit other possible private embodiments within the framework of the utility model formula.

The inventive device operates as follows.

To assist a patient with a Bartholin gland cyst or Bartholin gland abscess, the cyst or abscess is opened with a linear incision in a typical location under local or intravenous anesthesia. Next, the partitions in the cavity of the capsule of the cyst or abscess are mechanically destroyed, the cavities are washed with an antiseptic solution (chlorhexidine, prontosan, etc.). Next, body 1 is inserted into the cavity of the cyst or abscess so that the “ears” 3 remain outside. The edges of the cyst or abscess capsule are fixed with biodegradable polyfilament sutures No. 0 in two places to the edge of the vaginal mucosa through holes 2 in the “ears” 3 with four knots. The device is then left in the cavity of the cyst or abscess for at least three weeks. In this case, the liquid exits through the drainage holes 5 at the ends and through the holes 4, if any. If necessary, the cavity of the cyst or abscess is washed with antiseptic solutions through drainage hole 5. After 21 days, the sutures are cut off, the device is removed and disposed of. In this case, an artificial drainage hole is formed at the place where the device is fixed.

The claimed utility model is illustrated with examples.

Example 1.

Patient A at the age of 28 years. Diagnosis: Bartholin gland cyst. Based on the results of diagnostic measures, it was decided to perform drainage using the inventive device.

For this purpose, we used a device with a silicone body with a hardness of Shore A 75. The body had “ears” with holes, two drainage holes in the side and two at the ends. The distance between the edges of the body and the holes closest to them, as well as between the holes themselves, was the same.

The patient had her cyst opened with a linear incision under local anesthesia. The septum in the area of the cyst capsule was mechanically destroyed and the cavity was washed with chlorhexidine. The body was inserted into the cyst cavity. The edges of the cyst capsule were fixed with a biodegradable thread to the edge of the vaginal mucosa using ears and holes in them. The device was left in place for three weeks, after which the sutures were cut and the device was removed and disposed of.

The patient was monitored as the device was located and afterwards. The use of the inventive device provided effective drainage.

Example 2.

Patient A, age 33. Diagnosis: Bartholin gland cyst. Based on the results of diagnostic measures, it was decided to perform drainage using the inventive device.

To do this, we used a device with a silicone body with a hardness of Shore A 82. The body had “ears” with holes, two drainage holes in the side and two at the ends. The distance between the edges of the body and the holes closest to them, as well as between the holes themselves, was the same.

The patient had her cyst opened with a linear incision under local anesthesia. The septum in the area of the cyst capsule was mechanically destroyed and the cavity was washed with chlorhexidine. The body was inserted into the cyst cavity. The edges of the cyst capsule were fixed with a biodegradable thread to the edge of the vaginal mucosa using ears and holes in them. The device was left in place for three weeks, after which the sutures were cut and the device was removed and disposed of.

The patient was monitored as the device was located and afterwards. The use of the inventive device provided effective drainage.

Example 3.

Patient A, aged 19 years. Diagnosis: Bartholin gland cyst. Based on the results of diagnostic measures, it was decided to perform drainage using the inventive device.

To do this, we used a device with a silicone body with a hardness of Shore A 78. The body had “ears” with holes, two drainage holes in the side and two at the ends. The distance between the edges of the body and the holes closest to them, as well as between the holes themselves, was the same.

The patient had her cyst opened with a linear incision under local anesthesia. The septum in the area of the cyst capsule was mechanically destroyed and the cavity was washed with chlorhexidine. The body was inserted into the cyst cavity. The edges of the cyst capsule were fixed with a biodegradable thread to the edge of the vaginal mucosa using ears and holes in them. The device was left in place for three weeks, after which the sutures were cut and the device was removed and disposed of.

The patient was monitored while the device was located and afterwards. The use of the inventive device provided effective drainage.

Example 4.

Patient A, age 31. Diagnosis: abscess of the Bartholin gland. Based on the results of diagnostic measures, it was decided to perform drainage using the inventive device.

To do this, we used a device with a silicone body with a hardness of Shore A 75. The body had “ears” with holes, two drainage holes in the side and two at the ends. There was an equal distance between the edges of the case and the holes closest to them, and the distance between the holes themselves was less than the distance of the hole from the edge of the case.

The patient had her abscess opened with a linear incision under local anesthesia. The partitions in the area of the abscess capsule were mechanically destroyed and the cavity was washed with benzalkonium chloride. The body was inserted into the abscess cavity. The edges of the abscess capsule were fixed with a biodegradable thread to the edge of the vaginal mucosa using ears and holes in them. The device was left in place for three weeks, after which the sutures were cut and the device was removed and disposed of.

The patient was monitored as the device was located and afterwards. The use of the inventive device provided effective drainage.

Example 5.

Patient A at the age of 25 years. The diagnosis is abscess of the Bartholin gland. Based on the results of diagnostic measures, it was decided to perform drainage using the inventive device.

To do this, we used a device with a latex body with a hardness of Shore A 75. The body had “ears” with holes and two drainage holes at the ends.

The patient had her abscess opened with a linear incision under local anesthesia. The partitions in the area of the abscess capsule were mechanically destroyed and the cavity was washed with benzalkonium chloride. The body was inserted into the abscess cavity. The edges of the abscess capsule were fixed with a biodegradable thread to the edge of the vaginal mucosa using ears and holes in them. The device was left in place for three weeks, after which the sutures were cut and the device was removed and disposed of.

The patient was monitored as the device was located and afterwards. The use of the inventive device provided effective drainage.

After performing the five above operations, doctors noted the simple design, as well as the simplicity and effectiveness of fixing the drainage. In this case, the most convenient option was chosen, presented in example 3.

Claims (5)

1. A device for draining the Bartholin gland, including a body in the form of a hollow cylinder with drainage holes at the ends and holes for fixation, characterized in that on the body, near its edge, ears are radially coaxial, each of which contains the said hole for passing the fixing thread , while additional drainage holes are made on the side of the body. 2. The device according to claim 1, characterized in that the body is made of silicone. 3. The device according to claim 1, characterized in that the body is made of latex. 4. The device according to claim 1, characterized in that the body has a Shore A hardness of 75 to 82. 5. The device according to claim 4, characterized in that the body has a Shore A hardness of 78 or more.